Research
Micronutrients & recovery
Immune-modulating nutrition (supplementation with glutamine, arginine, omega-3 fatty acids, and antioxidants) does not improve outcomes in general critically ill patients and may increase mortality, although it may benefit specific subgroups like severe burn patients.
Do not routinely use immune-modulating supplements (glutamine, arginine, omega-3s) for general critically ill patients. These supplements have been shown to increase mortality or provide no benefit in large trials. They may be considered for specific subgroups like severe burn patients, but this requires specialist judgment.
GoodRefutesHIGH confidence
The REDOXS trial showed an increase in mortality with high doses of enteral and parenteral glutamine... The OMEGA trial showed that enteral supplementation of n-3 fatty acids... did not improve the primary endpoint... and might be harmful.
Why this rating
Supported by multiple large RCTs (REDOXS, OMEGA, MetaPlus) and meta-analyses.
Source
The intensive care medicine research agenda in nutrition and metabolism
Yaseen M. Arabi et al. · Intensive Care Medicine · 2017
DOI 10.1007/s00134-017-4711-6
narrative_reviewCited 209×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Early aggressive provision of full caloric and protein targets in critically ill patients provides no clinical benefit and may cause harm, whereas permissive underfeeding (restricted feeding) during the acute phase reduces ICU-acquired weakness and improves outcomes.Good
- Tight glucose control (targeting 4.4-6.1 mmol/L) increases mortality in critically ill patients compared to a less strict target (less than 10 mmol/L), and optimal targets may vary based on diabetes status.Good
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